After treatment for melanoma, the patient’s follow-up screenings eventually default to yearly, when initially they are every three to six months for up to two years after diagnosis.
After melanoma treatment, the patient sees his dermatologist every 3-6 months for up to two years, and if there are no additional signs of melanoma during that time period, the follow-up exams go down to just once a year.
What’s puzzling is that the annual melanoma screening is what dermatologists recommend for the general population.
You may be thinking that over the span of 12 months, a newly-developing melanoma can progress quite a bit and be missed by the patient’s monthly self-exams.
The miss may occur either because the changes in a mole (over only a few months or even six months) are difficult to detect with the naked eye.
Or, a new skin lesion is too small to even be noticed, especially if it’s on one’s back; or, the developing melanoma is in a hard-to-view area of the body, such as the back and scalp.
“Patients diagnosed with melanoma are at significantly increased risk of developing additional melanomas in the future,” says Joshua L. Fox, MD, founder and director of Advanced Dermatology, P.C., of New York and New Jersey.
“Most of these second melanomas are diagnosed in the first two years following diagnosis of the first melanoma.
“Thus, lifelong screening every six months may not be necessary unless the person has a lot of moles.”
In fact, in a person who has no personal history of melanoma, but has over 50 moles, or a large number of big, asymmetrical moles known as dysplastic nevi, he or she is often urged to get clinical screenings every six months.
Dr. Fox continues, “In my practice I suggest screening every six months after the first two years, since most patients are not meticulous in performing complete body exams (CBE) with two mirrors on at least a monthly basis, and are not so visually perceptive.”
Know your moles, should be your mantra, whether you’ve been diagnosed with melanoma or not.
Also bear in mind that most melanomas do not arise in pre-existing moles, so be acutely aware of new spots on the skin that don’t go away after a few weeks.
Much more likely, a new spot will be benign and may be the result of getting poked there, causing subcutaneous rupture of minute blood vessels, creating a little spot that appears to be a new mole.
Another benign explanation is a tiny 1-2 millimeter circular scab from getting jabbed by a fingernail, or a harmless skin barnacle known as a seborrheic keratosis (which are permanent).
In 1987 Dr. Fox founded the AAD Melanoma and Skin Cancer Prevention Program in Queens, NY. He has been chief of dermatology of several major teaching hospitals including Mt. Sinai Hospital of Queens.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.